Impact of Completeness of Revascularization by Coronary Intervention on Exercise Capacity Early After Acute ST-elevation Myocardial Infarction

Overview

Journal J Cardiothorac Surg

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2014 Mar 20

PMID 24641986

Citations 4

Authors

Wei Zhao

Jin Bai

Fuchun Zhang

Lijun Guo

Wei Gao

Affiliations

Soon will be listed here.

Abstract

Background: The importance of achieving complete revascularization by percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (MI) on exercise capacity remains unclear.

Objective: To compare exercise capacity early after acute ST-elevation myocardial infarction (STEMI), in patients receiving PCI with stenting, between those completely revascularized (CR) and those incompletely revascularized (IR).

Methods: We retrospectively reviewed 326 patients [single-vessel disease (SVD) group, 118 patients; multivessel disease (MVD) with CR group, 112 patients; MVD with IR group, 96 patients] who underwent cardiopulmonary exercise testing 7-30 days after STEMI to measure peak oxygen uptake (VO2peak), oxygen uptake at anaerobic threshold (VO2AT), and peak oxygen pulse. Demographic data, presence of concomitant diseases, STEMI characteristics, and echocardiography and angiography findings were evaluated.

Results: Most patients were male (89.0%) and mean age was 55.6 ± 11.2 years. Ischemic ST deviation occurred in 7.1%, with no significant difference between groups. VO2peak and VO2AT did not differ significantly between groups, despite a trend to be lower in the CR and IR groups compared with the SVD group. Peak oxygen pulse was significantly higher in the SVD group than in the IR group (p = 0.005). After adjustment for age, gender, body mass index, cardiovascular risk factors, MI characteristics and echocardiography parameters, CR was not an independent predictor of VO2peak (OR = -0.123, 95% confidence interval [CI] -2.986 to 0.232, p = 0.093), VO2AT (OR = 0.002, 95% CI 1.735 to 1.773, p = 0.983), or peak oxygen pulse (OR = -0.102, 95% CI -1.435 to 0.105, p = 0.090).

Conclusion: CR in patients with STEMI treated with PCI for multivessel disease might show no benefit on short-term exercise tolerance over IR.

Citing Articles

Determinants of Exercise Capacity Following ST-Elevation Myocardial Infarction (STEMI).

Klimis H, Ferkh A, Brown P, Zecchin R, Altman M, Thomas L J Cardiovasc Dev Dis. 2021; 8(11).

PMID: 34821693 PMC: 8624145. DOI: 10.3390/jcdd8110140.

Cardiac Rehabilitation of Patients with Acute ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention in a Han Population in Northern China: A Prospective Cohort Study.

Ma J, Tai Y, Fan M, Wang Z Int J Gen Med. 2021; 14:4959-4965.

PMID: 34483684 PMC: 8409762. DOI: 10.2147/IJGM.S326725.

Efficacy of CPET Combined with Systematic Education of Cardiac Rehabilitation After PCI: A Real-World Evaluation in ACS Patients.

Zhang Q, Hu Q, Li Y, Sun Y, He J, Qiu M Adv Ther. 2021; 38(9):4836-4846.

PMID: 34351565 PMC: 8408080. DOI: 10.1007/s12325-021-01871-y.

A practical clinical approach to utilize cardiopulmonary exercise testing in the evaluation and management of coronary artery disease: a primer for cardiologists.

Chaudhry S, Arena R, Bhatt D, Verma S, Kumar N Curr Opin Cardiol. 2017; 33(2):168-177.

PMID: 29240566 PMC: 5811236. DOI: 10.1097/HCO.0000000000000494.

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